an evacuation is not started when the plane takes off and is not over when it's landed
TRANSCRIPT
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An evacuation is not started when the plane takes off and is not over
when it's landed
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Stages of aeromedical evacuation
• Receiving information, organization
• Evaluation, preparation, packaging
• Transfer to an airport
• A flight
• Ambulance transfer to the receiving hospital
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How many times the patient should be moved after leaving the hospital bed?
• From hospital bed to hospital trolley
• Hospital trolley to an ambulance trolley
• Ambulance trolley to a stretcher in the plane
• From the stretcher to an ambulance trolley
• From ambulance to the bed in the receiving hospital
• Totally- 5 times or more
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Effects of air and ground transport physiological parameters of critically ill patientsBudiansky V, De Jong R, Chesmochakova L, Gagarin A, Loginov A
191
125
99
52
0
100
200
300
400
500загрузка больного
скорая помощь
подготовкабольного
самолет
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Potential problems with handling the patient
• The patient can be dropped
• Can be stacked
• ET can be dislodged, IV access can be lost etc.
• Decompensation of the patient
• Difficult to monitor, to ventilate
• Exposed to environment
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Some statistics
Adverse reactions 75%
Equipment failure 35.6%
Dislodgment ET,IV loss
15.3%
Our data 33.4 % - equipmentfailure
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Guidelines
• Systemic approach
• Thorough preparation
• Minimization of the patient movements
• Continuous monitoring
• The same level of support (treatment)
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Systematic approach
A assessment situation
C control team leader, tasks
C communication TMO
E evaluation clinical information
P preparation safety, transport unit
T transportation care during transport
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Transport unit
• Minimization of a patient movements
• Easy and safe handling at every stage
• Possibility of interventions and monitoring at every stage of evacuation
• Patients comfort
• Limitation of exposure to environment
• Possibility to carry of equipment
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Creating a transport unit
• basket stretcher
• vacuum mattress
• scoop stretcher
• spinal board
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Comparison
Size Comfort Protection
problems Handling
BS +++ ++++ ++++ size +++
VM ++ +++ +++ fragility ++
SS + ++ ++ Defib? +++
SB + + ++ P, P, R +++
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Your safety
• Gloves
• clothes
• technic
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Loading to the plane
• Ask permission
• Delegate responsibilities but be careful
• Communicate with pilots
• Belts
• Securing equipment
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Key points
• Thorough preparation (plan, patient, equipment, personnel)
• Team leader
• Transport unit
• Safety
• Communication (don’t forget to explain to the patient what you are going to do)